Archive for the ‘Artefil’ Category

Injection techniques to place filler into the face to correct lines, folds and wrinkles have became even more advanced with the use of blunt tip cannulae, such as Dermasculpt.
These are similar to needles except that they are not sharp and therefore are less prone to cut the tiny diameter blood vessels in and below the skin.

I don’t employ them to treat all areas of the face, since certain anatomical facial features require extremely precise placement of filler not afforded by blunt tip cannulae. They are ideal to inject larger areas which require generalized plumping or filling such as the temples, cheek hollows, brows and jawline.

I have injected most types of filler through them including Juvederm, Restylane, Belotero, Artefill, Aquamid and Radiesse.

Be prepared to hear some minor crackling noise, however, for the first minute or so similar to lettuce being cut!

Fat transfer is a brilliant way in order to fill up the lower eyelid circles which gradually appear with age as the mid facial fat sags southwards. Though one can inject any number of temporary and permanent fillers into the area with magnification (such as Juvederm®, Restylane®, Artefill®, Belotero®, etc.), one must remember that fat is an excellent solution. By filling out this dark circle/hollow, a smooth beautiful interface is created between the lower eyelid and the upper portion of the cheek. The harsh defining ledge of the lower bony orbit is smoothed out.

Here is a classic example of a strategic fat transfer to the lower lid. The results are permanent and natural appearing.

Note the harsh shadowing around the lower eyelid interface with her upper portion of her cheek. This is called the “tear trough” and worsens with age.

Note the smooth result that was obtained by softening the shadowing and ledge that defined her lower eyelid hollow. Fat transfer was performed in order to obtain this result.

Obviously, as we continue to age, the cheeks descends further thereby widening the “tear trough” or lower eyelid Hollow/dark circle. The fat that worked perfectly to bridge the gap is now inadequate since the gap has widened. The results of fat transfer should be permanent, however, as long as the surgeon adheres to proper fat harvest and transfer techniques.

For further information into how Dr. Randal Haworth of Beverly Hills(Certified by the American Board of Plastic Surgery), Call 310-273-3000

Dr Randal Haworth of Beverly Hills had discovered an incredibly effective way of diminishing those troublesome horizontal neck lines.

Only until recently has an effective method to erase horizontal neck lines or groves if you will been developed. Plastic surgeons have only offered neck lifts as a way to smooth these lines out and despite their efficacy in restoring youthful jawline and correct a “turkey neck”, they feel short in terms of treating those aging horizontal neck lines. As an alternative Botulinum toxin (Botox™, Dysport™, Xeomen™) can be injected into the platysmal bands of the neck and though it can “lift” the neck and lessen the aging cords of the neck, it does little to nothing to remove the horizontal lines.

I have found that judicious use of a filler strategically injected under magnification into the precise layer below the horizontal grooves can dramatically decrease or even erase the stubborn lines. I usually start with a temporary filler such as Juvederm™ or Radiesse™ and once the patient is satisfied, I can then graduate to a permanent filler such as Artefill™., one the former substances dissipate .

Here is a typical example of a before and after of a filler to the horizontal lines to the neck:

The Radix Graft

This lesser known anatomic point of the nose is often purposely overlooked by rhinoplasty specialist surgeons because of the challenges it poses to those attempting to alter it. It is represented by the angle formed by the uppermost portion of the nose as it blends into the forehead proper. Yes, altering this area does have a subtle, yet profound influence upon the final appearance of a nose job- it can differentiate an excellent result from a “so-so” one. The surgeon can raise the radix so that the nose blends into the forehead at a higher latitude as well as softly elevate the natural valley that can exist at this are if it is too deep. Furthermore, one can deepen the radix if too much bone is present between the eyeball and the bridge on profile view.

The ideal position of the radix lies approximately at the latitude of the upper eyelash/upper eyelid crease. Beverly Hills plastic surgeon, Dr Randal Haworth can raise it by placing a precisely shaped softened cartilage graft (usually harvested from the nasal septum or ear) with beveled edges onto the bone of the radix area. Alternatively the radix or nasion can be rasped or chiseled with specialized delicate instruments to a lower, deeper position.

Why does raising a radix from a low position improve the final appearance of a nose? Well, imagine two noses which are identical in shape and forward projection except that one has a low radix while the other has a high one. The one with the low radix is shorter compared to the one with the high. Now imagine two men, both with the same 34 inch waist, but one is short while the other tall. Who appears fatter? The short person does, of course. This same optical illusion applies to the nose with a low radix-it appears as it projects further out from the face as compared with the one with the higher radix and not necessarily in an attractive way.

The following photos represent a beautiful result of a corner lip lift and concomitant rhinoplasty in which the radix was raised.

Note where her radix point lies. It is lower than the level of her eyelash, making the nose look more projecting than it really is.

The result after a corner lip lift and a rhinoplasty with Radix enhancement.

Work here results in some extra swelling localized to the space between the eyebrows in the sense that it lasts a few days longer. Dr Haworth at the Haworth Institute has a few tricks up his sleeve to accelerate the resolution of the nasal swelling by injecting a dilute mix of Kenalog under the skin (and it is relatively painless) two weeks out. This “turbocharges” the swelling to go away!

Of course, the radix can also be augmented with a filler of some sort, such as fat, Radiesse, Juvederm, Aquamid and Artefill.